Costa Rica Travel Health Guide for US Travelers
A physician-reviewed health and safety guide for Americans traveling to the Republic of Costa Rica
As of 2026, the US advises Exercise Increased Caution in Costa Rica due to crime. Use added care after dark, on beaches, and when displaying valuables; follow local safety guidance. Always check the latest advisory at travel.state.gov before departing.
Before You Travel to Costa Rica
Plan a travel medicine visit at least 4–8 weeks before departure (sooner if you need yellow fever or multiple doses). Bring vaccine records, your full flight itinerary, and a list of medications. Requirements and risks depend heavily on which regions you visit and activities (urban, rural, wildlife, adventure).
Visit a Travel Clinic
Discuss vaccines and prescriptions based on CDC guidance for your specific route. Yellow fever rules may apply depending on prior countries — not only your destination.
Get Travel Insurance
US health plans often do not cover care abroad. Carry coverage that fits your activities and includes medical evacuation if you go remote.
Documents & Registration
Enroll in STEP at step.state.gov. Carry proof of yellow fever vaccination when your itinerary requires it.
Pack a Medical Kit
Prescriptions in original packaging, ORS, antidiarrheal meds, sunscreen, insect repellent, and a thermometer.
Water & Food Safety
Use sealed bottled or treated water when local tap quality is uncertain. Prefer hot, thoroughly cooked foods; peel fruits yourself.
Cash & Payments
Clinics may require upfront payment. Carry local currency plus a backup card; know your insurance billing process.
Yellow Fever in Costa Rica
What is Yellow Fever?
Yellow fever is a mosquito-borne viral disease found in parts of Africa and South America. Vaccination at an authorized center is the key prevention tool when required or recommended for your routing.
For Costa Rica itself, the main issue is whether entry rules tied to other countries apply to your flights — not local exposure risk.
Malaria in Costa Rica
If your lodging or activities place you in risk areas, your physician may prescribe antimalarial medication (for example atovaquone-proguanil or doxycycline).
Common first-line option when prophylaxis is indicated — use per prescription timing.
Alternative daily prophylaxis — discuss sun sensitivity and contraindications.
Weekly option for some travelers — review neuropsychiatric precautions with your clinician.
Fever during or after travel to lowland coastal areas warrants urgent evaluation and a detailed itinerary review.
Medication (if prescribed) plus repellent, nets, and permethrin-treated clothing reduces risk.
Recommended Vaccines for Costa Rica
The following vaccines are recommended or required by the CDC and WHO for US travelers to Costa Rica. Discuss your full list with your travel medicine physician, as recommendations may vary based on your itinerary, activities, and health history.
Required if arriving from yellow-fever risk countries or long layovers in those countries — not routinely required for direct US–Costa Rica travel. Allow ≥10 days before travel if needed.
Spread through contaminated food and water. Injectable vaccine lasts 2 years; oral vaccine lasts 5 years. Recommended for most travelers.
Transmitted through contaminated food and water. Two-dose vaccine series provides long-term protection. Strongly recommended for all travelers.
Spread through blood and body fluids. Three-dose series. Recommended especially for those receiving medical care, getting tattoos, or at risk of exposure.
Costa Rica is high-risk for rabies. Pre-exposure vaccine series (3 doses) strongly recommended for long-term travelers, outdoor adventurers, and those who may contact animals.
Due to rising global polio cases, a one-time adult booster is recommended for all international travelers. Verify your polio vaccination status before travel.
MMR Vaccine (Measles, Mumps, Rubella)
Measles cases are rising globally. Ensure you have received 2 doses of MMR vaccine. Adults born before 1957 are generally considered immune.
Ensure your Tdap (tetanus, diphtheria, pertussis) booster is up to date — within the last 10 years — before travel to any international destination.
Influenza Vaccine & COVID-19
Annual flu shot recommended before all international travel. Ensure COVID-19 vaccinations and boosters are current per current CDC recommendations.
Healthcare System in Costa Rica
In San José (Capital)
A small number of private clinics in San José offer modern equipment, internationally trained staff, and 24-hour emergency services. Quality varies greatly even between private facilities. Public hospitals lack basic resources and supplies. Medical staff may speak little or no English.
Outside San José
Healthcare infrastructure is severely limited in rural areas and provincial cities. Basic hospitals may lack medications, equipment, and trained staff. Access may also be restricted by poor road infrastructure. Medical evacuation to San José or South Africa may be required.
Payment Policy
Hospitals and doctors require cash payment upfront before providing treatment or admitting a patient. Credit cards are not accepted at most facilities. Carry sufficient local currency at all times. Most US health insurance plans do not cover care abroad.
The US Embassy in San José strongly recommends that all US travelers purchase supplemental insurance that includes medical evacuation coverage. Air evacuation to South Africa or Europe is frequently necessary for serious illness or injury and can cost $50,000–$150,000 USD or more without coverage. Services like MedJet Assist, International SOS, or Global Rescue are commonly used by travelers to Costa Rica.
Emergency Numbers in Costa Rica
Ambulance services in Costa Rica are unreliable, inadequately equipped, and often not available outside of San José. Emergency responders are not staffed with trained paramedics and frequently have little or no medical equipment. In an emergency, injured or ill travelers may fare better by using a private taxi (such as a UGO taxi) or private vehicle to reach the nearest major hospital rather than waiting for an ambulance.
US Embassy San José
Rua Presidente Houari Boumedienne #32, Miramar, San José
Phone: +506 2519-2000
Outside San José: +506 2220-3205
cr.usembassy.gov
US State Dept 24/7 Hotline
For US citizens in distress abroad:
From US/Canada: +1-888-407-4747
From abroad: +1-202-501-4444
Available 24 hours a day, 7 days a week.
STEP Enrollment
Register your trip at step.state.gov before departure. STEP allows the US Embassy to contact you during emergencies, natural disasters, or civil unrest and helps locate you if something goes wrong.
Nature & Weather Risks
Extreme Heat
Costa Rica's tropical climate means high temperatures and humidity, particularly in the north. Heat stroke is a genuine risk. Stay hydrated, wear lightweight loose-fitting clothing, limit outdoor exertion between 10am–4pm, and eat salty snacks to replace lost electrolytes.
Freshwater & Rivers
Leptospirosis and other water-associated risks increase after flooding. Avoid swimming in murky rivers; watch for flash-flood warnings in canyons.
Animal & Wildlife Risks
Do not touch, feed, or approach any animals. Dogs, bats, and monkeys pose rabies risk. Snakes, jellyfish, and scorpions are present in many regions. If bitten or scratched by any animal, seek medical care immediately even after rabies pre-exposure vaccination.
Earthquakes, Volcanoes & Flooding
Costa Rica is seismically active. Know evacuation routes at your lodging; avoid river crossings during heavy rain and heed volcano advisories.
Road Safety
Road conditions in Costa Rica range from poor to dangerous, especially outside San José. Driving at night significantly increases risk due to road hazards, unmarked obstacles, and limited lighting. Use reputable ground transport services and avoid driving after dark.
Sun & UV Exposure
UV radiation is intense in equatorial Africa. Apply sunscreen with SPF 30 or higher, wear a hat and protective clothing, and seek shade during peak hours. Sun exposure is further intensified if taking doxycycline for malaria prevention.
Crime, Violence & Safety Risks
Armed Robbery & Assault
Armed robberies, muggings, and assaults are common throughout Costa Rica, especially in San José. Two people on motorcycles following and robbing individuals — sometimes at gunpoint — is a documented tactic. Never physically resist a robbery attempt.
Carjacking
Carjackings occur in San José and surrounding areas, particularly at night and at traffic stops. Use armored or vetted private transport. Keep car doors locked and windows up. Do not stop in isolated or unfamiliar areas after dark.
Petty Crime & Theft
Pickpocketing, bag snatching, and burglaries are widespread. Do not display expensive jewelry, phones, cameras, or cash in public. Use hotel safes for valuables. Be particularly vigilant in markets, airports, and crowded areas.
Personal Safety Tips
Avoid walking alone at night. Avoid carrying large amounts of cash. Use only registered or app-based taxis (UGO). Keep a low profile and do not draw attention to yourself as a tourist. Vary your routines if staying for extended periods.
Civil Unrest & Demonstrations
Political demonstrations occur with little notice in Costa Rica and can turn violent. They may disrupt transportation and essential services. Monitor local news, avoid all protests and large crowds, and have an emergency evacuation plan that does not rely on US government assistance.
High-Risk Regions
Cabinda Province: history of armed conflict and political unrest. DRC border regions: cross-border violence and smuggling. San José marginalized neighborhoods: high crime at all hours. Consult the US Embassy security report before traveling to any of these areas.
Costa Rican prisons do not meet US standards and are often overcrowded with reports of violence. If arrested or detained, immediately request that officials notify the US Embassy in San José. Do not sign any documents without legal representation. Contact the US Embassy at +506 2519-2000 or the 24/7 State Department hotline at +1-888-407-4747.
Other Health Risks in Costa Rica
One of the most common illnesses affecting visitors to Costa Rica. Caused by contaminated food or water. Prevention: drink only bottled water, avoid raw foods and street food, wash hands frequently. Ask your doctor about carrying a standby antibiotic for treatment.
Transmitted by daytime-biting Aedes mosquitoes, particularly in urban and peri-urban areas. No vaccine is available for most travelers. Prevention is solely through insect bite precautions. Symptoms include high fever, severe headache, muscle and joint pain.
Associated with fresh water, flooding, and animal urine in tropical settings — avoid swimming in questionable rivers or ponds, especially after heavy rain.
Zika is present in Costa Rica. Pregnant travelers or those planning to become pregnant should consult a physician before travel. Zika infection during pregnancy can cause serious birth defects. Prevention relies on mosquito bite avoidance and barrier contraception.
Cases have been reported in Costa Rica since 2016, likely underreported. Spread by daytime Aedes mosquitoes. Causes fever, rash, and severe joint pain that can persist for months. A vaccine is available in some countries but is not widely recommended for most travelers. Prevent through insect bite precautions.
HIV prevalence is significant in Costa Rica. Practice safe sex and avoid unprotected contact. If you require medical procedures, ensure sterile equipment is used. The availability of safe blood products for transfusion may be limited — medical evacuation is preferable for major trauma.
Pre-Departure Checklist for Costa Rica
- See a travel medicine physician — bring your immunization records
- Get Yellow Fever vaccine and obtain your official Yellow Card certificate
- Obtain a prescription for antimalarial medication (Malarone, doxycycline, or mefloquine)
- Update all routine vaccines: MMR, Tdap, polio booster, flu, COVID-19
- Discuss Hepatitis A, Hepatitis B, Typhoid, and Rabies vaccines with your doctor
- Purchase comprehensive travel health insurance with medical evacuation coverage
- Enroll in STEP at step.state.gov
- Save emergency numbers: Police 113 | Ambulance 112 or 116 | Fire 115 | US Embassy +506 2519-2000 |
Note: Public ambulance response is inconsistent; for faster service, contact a private 24-hour clinic (e.g., San José Medical Center or Sagrada Esperança). - Pack DEET insect repellent (≥30%), long-sleeved clothing, and mosquito net
- Carry extra supply of all prescription medications plus basic first aid kit
- Arrange cash in local currency — hospitals require upfront payment
- Avoid walking alone at night and do not resist robbery attempts
- Avoid river crossings and canyons during heavy rain; know volcano/earthquake basics
- Drink only sealed bottled water — do not swim in fresh water
